EDM 29 EDMONTON AC 439(1) Borough of Edmonton REPORT OF THE Medical Officer of Health AND School Medical Officer FOR THE YEAR 1944 Jolly the Printer Ltd., T.U., 238, Fore Street, N.18 4213 68585 Borough of Edmonton REPORT OF THE Medical Officer of Health AND School Medical Officer FOR THE YEAR 1944 Jolly the Printer Ltd., T.U., 238, Fore Street, N.18 4213 Borough of Edmonton 1944 Her Worship the Mayor Councillor Mrs. F. Long, J.P. Deputy Mayor Alderman W. Preye. PUBLIC HEALTH COMMITTEE. Chairman : Councillor Mrs. A. M. Glover. Councillors J. A. G. Beattie, Mrs. E. B. Newsham, Mrs. E. F. Johnson W. Pullen, J. A. Ward, J.P., L. E. Berridge, Mrs. E. M. Moss. STAFF OF THE PUBLIC HEALTH DEPARTMENT Medical Officer of Health, School Medical Officer, and Supervisor for the Maternity and Child Welfare Services : D. Regan, B.A., B.Sc., M.B., Ch.B., D.P.H. (L'pool). Deputy Medical Officer of Health and Deputy School Medical Officer : Hilda R. Hay, M.B., Ch.B., D.P.H. (Resigned 30.5.44). Assistant Medical Officers and School Medical Officers : Catherine A. Goggin, M.B., B.Ch., B.A.O., D.P.H. Kathleen M. Hart, M.D. (Lond.), M.B., B.S., D.P.H. Margaret Sutcliffe, M.B., B.Ch., B.A.O., D.P.H. (Commenced 1.2.44.) Senior Sanitary Inspector : *abcd W. Tillcock, F.S.I.A., M.R.San.I. District Sanitary Inspectors : *abce G. H. Huckle. *abc J. P. Farrar. *abc F. Beilby. *abcf E. Dodsworth. *abc H. W. Grieves. *a A. Hurley, Miss (Female Sanitary Inspector) (Commenced 1.2.44) Chief Clerk : F. J. Nash, Cert.R.San.I. (In H.M. Forces). J. L. A. Saunders, Infectious Diseases Clerk, a A. E. Clarke, Records Clerk. (Seconded to Civil Defence duties). H. J. Weldon, Junior Clerk. (In H.M. Forces). S. Clayton, Shops Acts Inspector. Miss I. M. Bowie, Temporary Clerk. J. H. Cowlard, Laboratory Assistant. R. R. Holland, Temporary Clerk. Mrs. S. Machin, Temporary Clerk (Commenced 24.2.44). * Moiety paid under Public Health Act or by Exchequer Grant. a Certificated Sanitary Inspector. b Certificate of Meat and Food Inspector. c Inspector under the Petroleum Acts. d Inspector of Canal Boats. e Certificate of Smoke Inspector. f R.S.I. Sanitary Science as applied to Buildings and Public Works. 3 PREFACE. Public Health Department, Town Hall, Edmonton, N.9. Her Worship the Mayor, Alderman and Councillors of the Borough of Edmonton. Your Worship, Ladies and Gentlemen, I have much pleasure in presenting my tenth Annual Report for the year 1944, and the fifth under War-time conditions. The Report is compiled in accordance with the Ministry of Health Circulars and therefore once again contains only a brief outline of information. The BIRTH RATE continues to increase and it is a great pleasure to note the low MATERNAL MORTALITY and complete absence of any deaths from puerperal infection. The health conditions of the Borough in general are quite satisfactory, and I would like to say that quite a number of people in Edmonton live well into the 70-80 years of age group. During the War years when enemy action was at its highest the conduct and bearing of the Edmonton Citizens was a fact which I greatly admired ; under very difficult circumstances there were no signs of panic at any time, and at all times good feeling and cheerfulness prevailed. A matter that was of great concern to me, and for which I should express my gratitude and admiration, was the devotion of the General Practitioners of the Borough to their work both night and day. Many of them also served on Civil Defence duties, and there was no instance in which anyone of them failed to respond to the call of need when the enemy visited the Borough. I would like to thank them very heartily for their co-operation. My thanks are due to the Members of the Council for their help and assistance in getting through what was an exceedingly difficult year. I would also like to thank my Staff for their unfailing efforts and devotion to duty during these very trying times. I have the honour to be, Your Worship, Ladies and Gentlemen, Your obedient Servant,, D. REGAN, Medical Officer of Health. GENERAL STATISTICS. Area (in acres) 3,896 Population— Census of 1921 66,809 Census of 1931 77,652 Estimated by the Registrar-General for mid-year 1944 91,590 Number of inhabited houses and tenements at the end of 1944 25,950 Number of inhabited houses and tenements at the end of 1943 26,000 Rateable value, April, 1944 £738,578 Estimated product of Id. in the £ for the year ending March 31st, 1945 £3,000 Rates in the £ for the year ending March 31st, 1945 15s. 2d. 4 SOCIAL CONDITIONS. The extent of unemployment may be estimated by the following figures relating to :— (1) the number of free dinners given to schoolchildren, and (2) the actual figures supplied by the Director of Public Assistance. No. 1 is given purely on economic grounds. (1) Number of free dinners during 1943 88,457 ,, ,, paid ,, „ 1943 725,313 „ free „ „ 1944 67,007 „ „ paid „ „ 1944 590,916 The reduction in the number of dinners supplied compared with 194-3 due to second evacuation owing to flying-bomb attacks. (2) Figures re out relief :— For the year 1943— Persons. Amount. (a) Ordinary out-relief 1,669 £18,953 (b) Unemployed out-relief 13 8 1,682 £18,961 For the year 1944—- (c) Ordinary out-relief 2,163 £21,295 (b) Unemployed out-relief Nil Nil 2,163 £21,295 VITAL STATISTICS. Live Births. M. F. Total. Grand Total. Legitimate 973 858 1,831 Illegitimate 45 45 90 1,921 Birth-rate per 1,000 of population 20.97 Stillbirths. Legitimate 26 16 42 Illegitimate 1 1 2 44 Total of live and stillbirths 1,965 Rate per 1,000 total births 22.39 Deaths. .Number 497 480 977 Rate per 1,000 population 10.66 Deaths from Puerperal Causes. Deaths. Rate per 1,000 total (live and stillbirths). Puerperal and post-abortive sepsis — 0.00 Other maternal causes 2 1.01 2 1.01 5 Death rate of infants under one year of age. M. F. Total. Number 37 24 61 All infants per 1,000 live births 31.75 Legitimate infants per 1,000 legitimate live births 32.22 Illegitimate infants per 1,000 illegitimate live births 22.22 Deaths from Cancer (all ages) 175 „ „ Measles (all ages) 1 „ „ Whooping Cough (all ages) 4 „ „ Diarrhoea (under 2 years of age) 5 The following causes of death are supplied by the Registrar General and refer to deaths which were registered during the calendar year :— Cause of Death. M. F. Total Typhoid and para-typhoid fevers ... ... ... Cerebro-spinal fever 2 ... ... Scarlet fever ... ... ... Whooping cough 2 2 4 Diphtheria ... ... ... Tuberculosis of the respiratory system 31 23 54 Other forms of tuberculosis 5 6 11 Syphilitic diseases 2 2 4 Influenza 1 3 4 Measles ... 1 1 Acute Poliomyelitis and Polio-encephalitis ... ... ... Acute infective encephalitis ... ... ... Cancer of buccal cavity and oesophagus (M.) Uterus (F.) 6 7 13 Cancer of stomach and duodenum 14 13 27 Cancer of breast ... 14 14 Cancer of all other sites 69 52 121 Diabetes 6 9 15 Intra-cranial vascular lesions 31 41 72 Heart disease 102 111 213 Other diseases of the circulatory system 19 14 33 Bronchitis 37 27 64 Pneumonia 18 24 42 Other respiratory diseases 7 5 12 Ulcer of stomach or duodenum 14 5 19 Diarrhoea (under 2 years) 3 2 5 Appendicitis 1 1 2 Other digestive diseases 10 17 27 Nephritis 10 8 18 Puerperal and post-abortive sepsis ... ... ... Other maternal causes ... 2 2 Premature birth 10 5 15 Congenital malformations, birth injuries, infant diseases 18 8 26 Suicide 1 3 4 Road traffic accidents 6 ... 6 Other violent causes 31 26 57 All other causes 41 49 90 497 480 977 The two tables overleaf give the deaths of those registered during the 52 weeks ended 30th December, 1944. The slight difference between the tables overleaf in respect of the causes of death and the one supplied by the Registrar General is that the Registrar General is in possession of additional information on the matter. 6 MALES. Causes of Death ALL AGES to 1 1 to 2 2 to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 and over Cerebro-spinal Fever 2 ... ... ... 1 ... ... 1 ... ... ... ... Whooping Cough 2 1 1 ... ... ... ... ... ... ... ... ... Tuberculosis of the Respiratory System 32 ... ... ... ... 1 5 8 6 9 1 2 Other forms of Tuberculosis 7 ... ... ... ... 2 1 2 2 ... ... ... Syphilitic Diseases 3 ... ... ... ... ... ... 1 2 ... ... ... Influenza 1 ... ... ... ... ... ... ... ... 1 ... ... Cancer of Buccal Cavity and Oesophagus 6 ... ... ... ... ... ... ... ... 1 3 2 Cancer of Stomach and Duodenum 14 ... ... ... ... ... ... ... 3 4 5 2 Cancer of all other sites 71 ... ... ... ... 1 ... 5 12 19 23 11 Diabetes 6 ... ... ... ... ... ... ... 1 1 3 1 Intra-cranial Vascular Lesions 26 ... ... ... 1 ... 1 1 5 2 8 8 Heart Disease 103 ... ... ... ... ... 1 3 9 26 31 31 Other Circulatory Diseases 19 ... ... ... ... ... ... ... ... 3 6 10 Bronchitis 36 2 ... ... ... ... ... 1 3 5 13 12 Pneumonia 17 2 ... ... 1 ... 1 2 1 ... 6 4 Other Respiratory Diseases 8 ... ... ... ... ... l 1 ... 1 3 2 Ulcer of Stomach or Duodenum 15 ... ... ... ... ... ... 3 3 8 ... 1 Diarrhoea (under 2 years) 3 3 ... ... ... ... ... ... ... ... ... ... Appendicitis 2 ... ... ... ... ... 1 ... 1 ... ... ... Other Digestive Diseases 11 ... ... ... ... ... 2 1 1 2 4 1 Nephritis 10 ... ... ... ... ... ... 1 1 2 3 3 Premature Birth 11 11 ... ... ... ... ... ... ... ... ... ... Cong, mal., birth injuries, infant dis. 18 18 ... ... ... ... ... ... ... ... ... ... Suicide 1 ... ... ... ... ... ... 1 ... ... ... ... Road Traffic Accidents 6 ... ... ... 2 ... ... 1 1 ... 1 1 Other violence 31 1 2 2 3 5 7 2 2 7 All other causes 37 l ... ... 3 ... 1 1 4 4 9 14 Totals 498 38 1 1 10 8 17 38 62 90 121 112 7 FEMALES. Causes of death ALL AGES to 1 1 to 2 2 to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 and over Whooping Cough 2 1 1 ... ... ... ... ... ... ... ... ... Tuberculosis of the Respiratory System 26 ... ... ... ... 6 6 6 4 2 ... 2 Other forms of Tuberculosis 5 ... ... 1 1 2 ... ... ... 1 ... ... Syphilitic Diseases 2 ... ... ... ... ... ... ... ... 1 ... 1 Influenza 2 ... ... ... ... ... ... ... ... 1 ... 1 Measles 1 ... ... ... ... ... ... ... ... ... ... ... Cancer of Uterus 7 ... ... ... ... ... ... 1 1 1 3 1 Cancer of Stomach and Duodenum 15 ... ... ... ... ... ... 1 1 4 6 3 Cancer of Breast 14 ... ... ... ... 1 1 ... 5 4 3 ... Cancer of all other sites 51 ... ... ... ... 1 1 2 8 13 11 15 Diabetes 12 ... ... ... ... ... ... ... 3 ... 5 4 Intra-cranial Vascular Lesions 39 ... ... ... ... ... ... ... 3 3 14 19 Heart Disease 111 ... ... ... ... ... 4 4 5 10 25 63 Other Circulatory Diseases 15 ... ... ... ... ... ... ... ... 2 3 10 Bronchitis 27 ... ... ... ... ... ... ... ... ... 12 14 Pneumonia 24 6 1 1 ... ... 1 ... ... 3 5 7 Other Respiratory Diseases 5 ... ... ... ... ... l ... ... ... 3 1 Ulcer of Stomach and Duodenum 4 ... ... ... ... ... ... 1 ... 1 1 1 Diarrhoea (under 2 years) 1 1 ... ... ... ... ... ... ... ... ... ... Appendicitis 1 ... ... ... ... ... ... 1 ... ... ... ... Other Digestive Diseases 17 ... ... ... 2 1 2 3 2 ... 2 5 Nephritis 8 ... ... ... ... ... 1 2 ... 2 1 2 Puerperal and Post-abortive Sepsis ... ... ... ... ... ... ... ... ... ... ... ... Other Maternal Causes 2 ... ... ... ... ... 1 ... 1 ... ... ... Premature Birth 5 5 ... ... ... ... ... ... ... ... ... ... Cong, mal., birth injuries, inf. dis. 7 7 ... ... ... ... ... ... ... ... ... ... Suicide 3 ... ... ... ... ... ... 1 1 ... ... 1 Road traffic accidents ... ... ... ... ... ... ... ... ... ... ... ... Other violence 25 2 ... ... 2 3 3 3 2 ... 3 7 All other causes 48 ... 1 1 ... 3 5 1 5 5 8 19 Totals 479 22 4 3 5 17 26 26 42 53 105 176 8 INFANTILE MORTALITY. The deaths of infants under one year of age were as follows:— M. F. Total Legitimate 36 23 59 Illegitimate 1 1 2 37 24 61 The death rate of all infants per 1,000 live births was 31.75. The death rate of all infants under one month of age per 1,000 live births was 20.82. A detailed sub-division of the causes, etc., of these DEATHS is as follows:— MALES. Causes of Death Under 1 week Second Week Third Week Fourth Week Total under 1 month 1—3 months 3—6 months 6—9 months 9—12 months Total under 1 year Whooping Cough ... ... ... ... ... ... 1 ... ... 1 Diarrhoea ... ... ... ... ... 1 1 1 ... 3 Pneumonia ... ... ... 1 1 ... 1 ... ... 2 Bronchitis ... ... ... ... ... ... 2 ... ... 2 Premature Birth 8 1 1 1 11 ... ... ... ... 11 Atelactasis 9 ... ... ... 9 ... ... ... ... 9 Congenital Malformations 2 2 1 ... 5 ... ... ... ... 5 Other causes 1 ... ... 1 2 3 ... ... ... 5 Totals 20 3 2 3 28 4 5 1 ... 38 FEMALES. Causes of Death Under 1 week Second week Third week Fourth week Total under 1 month 1—3 months 3—6 months 6—9 months 9—12 months Total under 1 year Whooping Cough ... ... ... ... ... ... ... ... 1 1 Cerebral Haemorrhage 2 ... ... ... 2 ... ... ... ... 2 Pneumonia 1 ... ... ... 1 2 2 1 1 7 Congenital Malformations 1 ... ... ... 1 ... 1 ... ... 2 Premature Birth 4 1 ... ... 5 ... ... ... ... 5 Atelactasis 2 ... ... ... 2 ... ... ... ... 2 Bronchitis ... ... ... ... ... 1 ... ... ... 1 Gastro-enteritis ... ... ... ... ... 1 ... ... ... 1 Violence ... ... ... 1 1 ... ... ... ... 1 Totals 10 1 ... 1 12 4 3 1 2 22 9 COMPARATIVE STATISTICS. The Registrar-General has forwarded provisional figures relating to the country as a whole and to London, enabling comparisons to be made as follows :— Birth-rate per 1,000 population Death-rate per 1,000 births. From diarrhoea, etc., under 2 years Total deaths under 1 year Live Still England and Wales 17.6 0.50 4.8 46 London 15.0 0.42 10.1 61 Edmonton 20.97 0.48 2.6 31.75 Annual Death Rate per 1,000 of Population. All Causes Measles Scarlet Fever Whooping Cough Diphtheria Influenza England and Wales 11.6 0.01 0.00 0.03 0.02 0.12 London 15.7 0.00 0.00 0.04 0.01 0.08 Edmonton 10.66 0.01 0.00 0.04 0.00 0.02 The following table gives the number of births and deaths (registered) sub-divided into the four Wards of the Borough. It should be remembered that births are only those which occurred in Edmonton of residents; these are registered in Edmonton. Births-which take place outside the Borough are not included; this fact accounts for the difference between these figures and those supplied by the Registrar-General. The deaths include those taking place outside the Borough, the information being given quarterly by the Registrar-General. Ward Births Deaths Infant Deaths M. F. M. F. M. F. Bury Street 245 208 144 136 12 7 Church Street 181 149 111 121 8 5 Angel Road 156 141 121 101 7 5 Silver Street 211 201 127 141 11 5 Vagrants ... ... 2 ... ... ... 793 699 505 499 38 22 Laboratory Facilities. The Laboratory Services have again proved of great value by giving results at the shortest possible notice, on the spot. Both Practitioners and Staff have no difficulty in getting their specimens to the laboratory, and in that way immediate results, particularly in relation to Maternity and Day Nurseries, have proved of immense value. Medical Practitioners continue to make good use of the facilities at their disposal. 10 The following examinations were carried out in the Bacteriological Laboratory :— Nature of Examination. Positive. Negative. Total. Blood—Bleeding Time — — 1 Blood—Coagulation Time — — 2 Blood Counts — — 155 Blood—Fragility of Red Blood Cells — — 1 Blood—Sedimentation Rate — — 1 Blood—Urea Content — — 1 Blood—Van den Bergh Reaction — — 1 Blood—Widal Reaction — — 1 Breast Milk—Fat Content — — 14 Ear Swabs for presence of organisms — — 4 Eye Swabs for presence of Gonococci 1 6 7 Eye Swabs for presence of organisms — — 30 Faeces for presence of Blood — 2 2 Faeces for presence of Dysentery Bacilli 35 288 323 Faeces for presence of Ova — 3 3 Nasal Swabs for presence of Haemolytic Streptococci — 12 12 Sputa for presence of Tubercle Bacilli 6 35 41 Swabs for presence of C. Diphtheriae :— (a) From Suspect cages 29 484 513 (b) From Contacts 1 264 265 (c) From Carriers and old cases 6 36 42 Throat Swabs for presence of Haemolytic Streptococci — 44 44 Throat Swabs for Vincent's Angina 4 2 6 Urine—Bacteriological Examinations — — 134 Urine-—Chemical Examinations — — 221 Urine—Microscopical Examinations — — 186 Urine for presence of Tubercle Bacilli — 2 2 Vaginal Smears for presence of Gonococci — 10 10 Vaginal Smears for Trichomonas Vaginalis — 3 3 Vaginal Smears for presence of organisms — — 9 Total Number of Examinations 2,034 MILK (SPECIAL DESIGNATIONS) ORDER, 1936. 173 Samples of Designated Milks were examined in the Laboratory. Results were as follows :— Accredited Milk. 3 Samples were examined and all satisfied both the prescribed tests. Pasteurised Milk. 69 Samples were examined and 65 satisfied both the prescribed tests. 1 Sample failed to pass both the Phosphatase Test and the Bacterial Count Standard. 3 Samples failed to pass the Phosphatase Test only. Tuberculin Tested Milk. 64 Samples were examined and 49 satisfied both the prescribed tests. 12 Samples failed to pass both the Methylene Blue and Coliform tests. 2 Samples failed to pass the Methylene Blue Test only. 1 Sample failed to pass the Coliform Test only. 11 Tuberculin Tested (Pasteurised) Milk. 37 Samples were examined and 35 satisfied both the prescribed tests. 2 Samples failed to pass the Bacterial Count Standard only. Ambulance Facilities. The Council possesses four ambulances, housed at Willis Garage, Weir Hall, and the following figures give some idea of the work carried out during the year :— Private cases 6,597 Accident cases 732 Maternity cases 192 School Medical Dept. (Tonsils) 223 Maternity and Child Welfare (Tonsils) 78 Not required 148 False calls 13 Bedside Apparatus 51 Analgesia 76 Special services 381 8,497 Children's Accidents 146. Factory Accidents 113. Street Accidents 226. First Aid was rendered on 338 occasions. The resusitating apparatus was in use on 6 occasions. The total mileage of the vehicles was 40,546 miles. Transport. A 2-ton Bedford Coach conveys the deaf and dumb and partially blind children to and from school, picks up a few other children in the morning, taking them to a spot to meet the guide. Nursing in the Home. This has been described in previous reports. Hospitals. Infectious diseases are admitted into the Enfield, Edmonton and Potters Bar Joint Isolation Hospital, situated in Enfield. Arrangements for the treatment of ear, nose, and throat disorders amongst school children are made with the E.M.S. Hospital, Goodmayes, Essex, and later in the year with the Royal Waterloo Hospital. Both hospitals served us very well under the very extenuating circumstances which they had to work. Nursing Homes Registration. There is one Nursing Home registered by the Council. This is kept under supervision by the Medical Officer of Health. No new applications to be placed on the register were received during 1944. SANITARY CIRCUMSTANCES OF THE AREA. The water supply of the Borough has at all times been satisfactory both in quality and quantity. The Metropolitan Water Board is responsible for the supply which is piped direct to every dwelling-house throughout the Borough, and serves the entire population. The co-operation of the Board has at all times been of the fullest. 12 SANITARY INSPECTION IN THE AREA. Five District Sanitary Inspectors and one woman Sanitary Inspector are engaged in the sanitary supervision of the Borough, working under the supervision of the Senior Sanitary Inspector. The Senior Sanitary Inspector supervises the work of the Borough and is Inspector under the Canal Boats Acts. At the outbreak of hostilities the Senior Sanitary Inspector was appointed Controlling Officer for Emergency Petrol Supplies and also the Authorised Officer for the Decontamination of Food (Food Decontamination Officer). Sanitary Conveniences. There are seven Public Conveniences in the Borough which are kept under constant supervision by the Public Health Department. Rats and Mice (Destruction) Act, 1919. Infestation Order, 1943. Under this heading your Senior Sanitary Inspector, as Officer-in-Charge, Rodent Control, reports as follows :— In February last, when the Act came into operation in this Borough, the Council appointed two Rodent Operatives and a Junior Clerk, and appointed the District Sanitary Inspectors Rodent Officers. Up to the end of the year, 2,504 visits and re-visits have been made by the Rodent Operatives, in connection with complaints as to alleged rat infestation. Seventy-four Intimation Notices have been served—owing to the fact that the Occupiers did not appear to be taking effective measures to eradicate the vermin, and one Statutory Notice was served. Defestation has been carried out on request at 106 premises and at the end of the year 26 premises were in process of " Defestation." The District Sanitary Inspectors in cases where there was a possibility of the infestation being due to defective drainage visited the premises and tested the drainage and any defects discovered were dealt with through the usual channels. Of 193 cases of Rat Infestation referred to the District Inspectors, owing to the possibility of defects in the drainage, in 101 cases defects were discovered and as one can quite appreciate entailed quite a large amount of work. Middlesex County Council (General Powers) Act, 1938, Section 71, Hawkers, Etc. This Act came into operation on the 1st January, 1939, the Council together with other Local Authorities considered the adoptive sections and put the necessary resolutions and action into being regarding Sections 70 and 71. No new applications were received during 1944. Disinfection and Disinfestation. The following table gives some idea of the work carried out :— Number of journeys to collect bedding 274 ,, „ ,, ,, return bedding 266 Rooms disinfected after infectious disease 730 „ ,, ,, phthisis 104 Disinfestation carried out after vermin 216 Bedding, clothing, etc., disinfected after infectious disease 4,427 articles Bedding, clothing, etc., disinfected after phthisis 650 „ ,, „ „ „ „ other cases 2,690 „ 13 The Council distribute a disinfecting powder and fluid to residents who apply for same at the Town Hall Yard. During the year, the applicants numbered 10,015. One hour daily is allowed for such distribution with the exception of Fridays and Saturdays. A Formalin Chamber is used for the disinfection of books, leather goods, etc., articles that would be damaged by steam. The number of books and other articles thus disinfected was 413. Five Council houses and 101 other houses were found to be infested and the total number of rooms disinfested was 216. The whole of the work is carried out by the Department, the materials used being Block Disinfestators combined with the use of Insecticides. Petroleum (Regulations) Acts, 1928 and 1936. During the year one new licence and 104 renewals were granted by the Council. Ihe following is a list of particulars of quantities, etc., affected by these licences :— Petroleum spirit 461,683 gallons. Petroleum mixtures 8,028 Carbide of calcium 1 ton 17 cwts. 78 lbs. Mortuary. During the year 86 bodies were deposited in the Mortuary, 76 by order of the Coroner and 10 for sanitary reasons. Inspections. The following tabular statement gives the number and nature of the inspections made during the year :— Complaints 1,742 Infectious disease 358 Tuberculosis 54 Factories with mechanical power 318 Factories without mechanical power 15 Other premises under the Factories Act 2 Outworkers 324 Schools — Offensive trades 6 Shops and Stalls 326 Shops Act (Primary) 12 Shops Act (Re-inspections) 10 Sanitary conveniences and urinals 466 Smoke observations 30 Stables 25 Piggeries 56 Petroleum 17 General inspections 256 Sundry Visits 2,239 Cinemas and Halls 7 Visits to canal 5 A.R.P. Shelters 57 Re-inspections 5,142 Inspection of Places where Food is Prepared. Butchers 201 Fish shops 35 Coffee shops 112 Dairies and milkshops 94 Slaughterhouses 73 Bakehouses 45 14 Number of Notices Served. Preliminary or Informal Notices 1,332 Statutory Notices 295 Defects Remedied. Houses repaired, cleansed, etc 378 D.W. cisterns repaired, covered 13 Water fittings repaired 115 Drains examined, tested, etc. 620 Drains cleared, trapped, repaired 427 Drains reconstructed 59 Chambers inserted 51 Chambers sealed down 29 Soil and vent pipes repaired 42 W.C.s repaired, cleansed, etc. 183 Flushing cisterns repaired 131 Waste pipes repaired, etc. 80 Sinks repaired or renewed 52 Roofs repaired 318 Gutters and R.W.P.s repaired 182 Yards paved or repaved 73 Scullery floors repaired 40 Spaces under floors ventilated 63 Dampness remedied 90 Floors repaired 82 Coppers and stoves repaired, etc 99 New dustbins supplied 177 Accumulation of refuse removed 37 Nuisances from animals abated 6 Other nuisances abated 254 Water supply restored 7 Canal Boats Acts. During the year 4 visits were paid to the Canal and 5 boats were seen, but of this number none was fitted or used as a dwelling or registered under the Acts. Places of Public Entertainment. Seven inspections of cinemas and other places of entertainment were made in accordance with the Circular of the Ministry of Health of 1920. Conditions were found to be generally satisfactory. FACTORIES ACT, 1937. The following work has been carried out under the above Act :— 1.—Inspections for the Purpose of Provisions as to Health. Premises Inspections Written Notices Occupiers Prosecuted Factories with mechanical power 318 12 ... Factories without mechanical power 15 Other premises under the Act (including works of building and engineering and construction but not including outworkers' premises) 2 ... ... Totals 335 12 ... 15 2.—Defects Found. Particulars Number of defects No. of defects fti respect of which prosecutions were instituted Found Remedied Referred to H.M. Inspector Want of cleanliness 31 31 ... ... Overcrowding ... ... ... ... Unreasonable temperature ... ... ... ... Inadequate ventilation ... ... ... ... Sanitary Conveniences : Insufficient 1 1 ... ... Unsuitable or defective 45 45 ... ... Not separate for sexes 2 2 ... ... Other offences ... 1 1 ... ... (Not including offences relating to Home work or offences under Sections mentioned in the schedule to the Ministry of Health (Factories and Workshops Transfer of Powers) Order, 1921, and re-enacted in the Third Schedule to the Factories Act, 1937.) Totals 80 80 ... ... 3.—Outwork in Unwholesome Premises. Nature of Work. Instances. Notices Served. Prosecutions. Wearing ApparelMaking, etc«. — — — Cleaning and washing — — — FACTORIES. Defects Remedied. W.C. walls cleansed 30 W.C. cisterns repaired 5 W.C. Seats repaired or renewed 16 W.C. Flush pipes repaired 4 W.C. doors repaired 5 W.C. pans replaced 8 Roofs repaired 4 Workrooms cleansed 2 Sanitary accommodation improved 2 „ „ for Sexes provided 1 Urinals cleansed 3 HOUSING—HOUSING ACT, 1936. 1. Inspection of Dwelling Houses During the Year :— (1) (a) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 1,173 (b) Number of inspections made for the purpose 4,697 (2) (a) Number of dwelling houses (including under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 — (b) Number of inspections made for the purpose — 16 (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation (4) Number of dwelling houses (exclusive' of those referred to above under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 937 2. Remedy of Defects During the Year without Service of Formal Notices :— Number of defective dwelling houses rendered fit in consequence of informal action by the Local Authority or their officers 762 3. Action under Statutory Powers During the Year. A.—Proceedings under Sections 9, 10, and 16 of the Housing Act, 1936 :— (1) Number of dwelling houses in respect of which notices were served requiring repairs 94 (2) Number of dwelling houses which were rendered fit after service of formal notices :— (a) By owners 43 (b) By Local Authority in default of owners 19 B.—Proceedings under Public Health Acts :— (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 42 (2) Number of houses in which defects were remedied after service of formal notices :— (a) By owners 25 (b) By Local Authority in default of owners 12 C.—Proceedings under Sections 11 and 13 of the Housing Act, 1936 :— (1) Number of dwelling houses in respect of which demolition orders were made — (2) Number of dwelling houses demolished in pursuance of demolition orders — D.—Proceedings under Section 12 of the Housing Act, 1936 :— (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made — (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenements or rooms having been rendered fit. — SLAUGHTERHOUSES. Seventy-four visits were paid and the carcases and organs of 342 pigs were inspected during or shortly after slaughter, permission for slaughter having been obtained from the Area Meat and Livestock Officer, and the following surrendered :— 2 Carcases (Weight 140 lbs.). 92 Plucks ( „ 40 lbs.). 1 Head. 5 Livers. 15 Sets of Lungs. 17 INSPECTION AND SUPERVISION OF FOOD. Milk Supply. Various licences were granted as under :— Primary. Supplementary. Pasteurised 11 7 Tuberculin tested 7 5 18 12 One of the above retailers is licensed to bottle Tuberculin tested milk and one firm is licensed to pasteurise and bottle milk on the premises; one firm is licensed to bottle pasteurised milk on the premises. Supplementary licences are granted to retailers who live outside the Borough but who sell milk in the Borough ; the primary licence is granted by the Authority in which they reside. Unsound Food. The following is a list of the food surrendered for examination and retained as unfit for human consumption :— 426 tins milk. 9 rabbits. 160 tins beans. 257 lbs. prunes. 450 tins canned fish. 93 lbs. sugar. 293 tins canned meat. 62 tins Yorkshire pudding flour. 56 pots jam. 22 tins egg substitute. 15 tins fruit. 47 bottles pickles. 13 cwt. " Soya " flour. 72 pkts. biscuits. 395 pkts. Glenmar Products. 25 lbs. raisins. 312 lbs. Goteborg Sausage. 292 lbs. pork. 3 doz. " Tesco " bun flour. 200 lbs. tripe. 12 calves livers. 72 tins pancake mixture. 247 lbs. rolled oats. 32 tins beetroot. 12 boxes tomatoes. 16 tins soup. 3 boned legs of pork. 19 lbs. tea. 1 leg mutton. 40 tins Yorkshire peas pudding. 82 lbs. mixed fish. 3 boxes haddock. 5 stone roe. 3 boxes flats. 1 cwt. dog fish. 3½ stone herrings. 2 boxes skate. 60 lbs. fillets. 1 cwt. cod. Together with various small consignments of miscellaneous foods. The above items do not include the food dealt with at shops subjected to damage on account of " Enemy action." Shops Acts. The Shops Acts Inspector submits a monthly report to the Public Health Committee, and the following is a short summary :— Visits to shops, licensed street traders, etc. 3,241 Contraventions — Chemical and Bacteriological Examinations of Food. The only examinations carried out by the Council are those for designated milks. The matter has been discussed previously. 18 PREVALENCE OF INFECTIOUS DISEASE. Measles and Whooping Cough. These diseases were made compulsorily notifiable in October, 1939. 253 cases of Measles and 261 cases of Whooping Cough were notified during the year. There was one death from Measles and 4 deaths from Whooping Cough. Diphtheria. I am happy to report the continued low incidence of this disease. Thirty cases were notified during the year compared with 92 in 1943. There were no deaths. Scarlet Fever. This disease continued to occur throughout the year in a mild form; there were 256 cases compared with 540 in 1943 ; there were no deaths. " Return " cases numbered 2 allowing for an interval of 28 days between a patient returning home from the Isolation Hospital and the onset of the disease in another inmate of the house. Smallpox. No cases of smallpox were notified during the year. Poliomyelitis. No cases of this disease were notified during the year. Dysentery. Ninety-nine cases were notified during the year of the Sonne type, and investigation failed to reveal the cause of infection. The increase of this disease over 1943 was due to an outbreak occurring in the North Middlesex County Hospital during the first two months of the year (52 cases). There were no deaths from this disease. Cerebro Spinal Fever. Seven cases were notified during the year. These cases were carefully investigated and precautions taken to prevent the spread of infection. Two deaths took place. Puerperal Pyrexia and Ophthalmia Neonatorum. These are referred to later on under the heading of Maternity and Child Welfare. Food Poisoning. No cases were notified during the year. Pneumonia. Forty-four cases were notified during the year. Diarrhoea and Enteritis under 2 years of age. The death rate per 1,000 live births for London was 10.1 whilst that for Edmonton was 2.6 as compared with 10.4 and 7.29 respectively last year. IMMUNISATION. Diphtheria. During the year, 1,280 appointments were made—1,115 children completed treatment under the Council's arrangements; of these 858 were under 5 years of age. Twenty-three children were Schick tested. In 1943, 2,671 children completed immunisation treatment. Measles. Measles Immune Globulin. None was issued to general practitioners during the year. 19 Whooping Cough. Edmonton children are immunised against Whooping Cough. The material used is "Vaccine A," and during the year, 751 appointments were made for this treatment—488 children completed treatment. The following table gives the age, incidence, etc., of those suffering from notifiable diseases, excluding tuberculosis which is dealt with separately. It must be noted that the figures in the second column " No. removed to hospital "includes those already under treatment at a hospital, for instance, the North Middlesex County Hospital. This remark applies more particularly to the infections associated with parturition and includes puerperal pyrexia and ophthalmia neonatorum. The number of deaths from Pneumonia includes all forms of this disease. Disease Total No. of Cases No. Removed to Hospital Deaths to 1 1 to 2 2 to 3 3 to 4 4 to 5 5 to 10- 10 to 15 15 to 20 20 to 35 35 to 45 45 to 65 65 and over Scarlet Fever 256 230 ... ... 1 9 18 15 149 39 5 12 5 3 ... Diphtheria 30 30 ... ... ... 1 1 7 9 5 4 ... 1 ... Puerperal Pyrexia 81 81 ... ... ... ... ... ... ... ... 6 60 15 ... ... Pneumonia 44 4 41 4 ... 1 1 ... 5 3 3 5 6 11 4 Erysipelas 43 15 1 ... ... 1 ... ... 1 3 1 6 12 15 4 Ophth- Neonatorum 20 18 ... 20 ... ... ... ... ... ... ... ... ... ... ... Dysentery 99 77 ... 1 11 4 5 2 13 2 5 18 3 15 20 Whooping Cough 261 10 4 24 43 30 36 35 77 10 1 5 1 1 ... Measles 253 6 1 8 27 20 20 37 116 13 5 6 1 ... ... C.S.F 7 7 2 3 ... ... ... ... 1 1 ... 1 1 ... ... The following table indicates the Wards from which the various cases were notified :— Disease Bury Street Ward Church Street Ward Angel Road Ward Silver Street Ward N. Middx. C. Hosp. Other Instns. Total Scarlet Fever 61 107 25 59 4 ... 256 Diphtheria 18 2 3 7 ... ... 30 Puerperal Pyrexia 10 3 5 5* 54 4 81 Pneumonia 27 6 7 4 ... ... 44 Erysipelas 13 3 12 14 l ... 43 Ophth-N eonatorum 3 ... ... 4 12 1 20 Dysentery 18 5 5 18 52 1 99 Whooping Cough 76 73 59 53 ... ... 261 Measles 69 70 80 34 ... ... 253 C.S.F 3 ... ... 2 2 ... 7 20 CANCER. The incidence of Cancer relative to the various organs of the body is given as under :— Males. Females. Breast — 14 Uterus — 7 Buccal cavity and oesophagus 6 — Stomach and duodenum 14 15 All other sites 71 51 91 87 PREVENTION OF BLINDNESS. Cases of ophthalmia neonatorum are promptly visited and, if thought necessary, are removed to hospital for treatment. No cases of blindness have arisen during the year due to this cause. As provided by Section 176 (1) of the Public Health Act, 1936, arrangements exist with the Middlesex County Council for the treatment at the school clinics of adolescents who are ascertained at school to be suffering from defective vision. ORTHOPAEDIC TREATMENT. Details of this scheme were set out in my Report for 1939. Financial assistance was rendered for the supply of surgical appliances in 2 cases during the year. ESTABLISHMENTS FOR MASSAGE OR SPECIAL TREATMENT. In 1941 the Council resolved that Part 7 of the Middlesex County Council Act, 1934, be put into operation in the Borough. TUBERCULOSIS. The table below gives details of the ages and sex of new cases of Tuberculosis, also deaths from the disease; this latter figure includes the deaths of non-notified cases. Age Periods New Cases Deaths Respiratory Non-respiratory Respiratory Non-respiratory M. F. M. F. M. F. M. F. Under 1 year ... ... ... ... ... ... ... ... 1— 5 years 3 2 ... 1 ... ... ... 1 5—15 „ 3 2 5 3 ... ... ... 1 15—25 „ 18 21 2 6 1 6 2 2 25—35 „ 13 10 ... ... 5 6 1 ... 35—45 16 8 1 ... 8 6 2 ... 45—55 7 2 1 ... 6 4 2 ... 55—65 9 2 ... ... 9 2 ... 1 65 years upwards 1 2 ... ... 3 2 ... ... 70 49 9 10 32 26 7 6 21 In addition 5 cases of pulmonary tuberculosis and one case of non-pulmonary tuberculosis previously notified in other areas, moved into Edmonton. The total number of names added to the Register for the first time during the year, excluding of course, non-notified deaths was :— Males. Females. New cases (respiratory) 70 49 (non-respiratory) 9 10 Transferred cases (respiratory) 3 2 (non-respiratory) 1 — 83 61 The cases dying of Tuberculosis and not previously notified were :— Males. Females. Respiratory 4 3 Non-respiratory 1 — There were thus 8 non-notified deaths out of a total of 71 persons registered as dying of tuberculosis (Registrar's figures). Regarding the non-notification of the above cases, there was no suggestion of wilful neglect or of refusal to notify. The non-respiratory forms of tuberculosis notified were :— Males. Females. Genito-urinary tract 1 1 Other bones and joints 1 3 Meningeal — 2 Glands 4 2 Spine 2 — Abdomen 1 1 Peritoneum — 1 The Public Health (Prevention of Tuberculosis) Regulations, 1925, relate to tuberculous employees in the milk trade; whilst section 172 of the Public Health Act, 1936, gives power to the Local Authority to remove to hospital certain cases of tuberculosis which are dangerous to other people. No occasion during the year had occurred in which it has been necessary to invoke those powers. Public Health (Tuberculosis) Regulations, 1930. The number of cases of tuberculosis on the Register at the end of 1944 was :— Males. Females. Total. Pulmonary forms 294 250 544 Non-pulmonary forms 76 69 145 370 319 689 The corresponding figures at the end of 1943 were :— Males. Females. Total. Pulmonary forms 325 267 592 Non-pulmonary forms 86 88 174 411 355 766 22 Corresponding figures for previous years were :— Males. Females. Totals. 1942 348 304 652 1941 355 293 648 1940 349 313 662 1939 357 301 658 1938 363 297 660 1937 336 260 596 1936 315 252 567 1935 330 265 595 1934 339 281 620 1933 320 281 601 COUNCIL'S EMPLOYEES. During 1944 the Medical Officer of Health paid a total of 286 visits to those employees who had been on the sick list for longer than a fortnight and, when necessary, at fortnightly intervals. Of these 58 were "not at home" and one had already resumed duty. Also, during the year, two persons were examined prior to their appointment to permanent posts. 23 MATERNITY AND CHILD WELFARE COMMITTEE. Chairman : Councillor Mrs. A. M. Glover. Councillors Mrs. F. Long (Mayor), Ald. W. Preye (Deputy Mayor). Councillors J. A. Beattie, L. E. Berridge, Mrs. E. F. Johnson, Mrs. E. M. Moss, Mrs. E. N. Newsham, W. Pullen and J. Ward, J.P. STAFF. D. Regan, B.A. B.Sc. M.B. Ch.B., B.A.O., D.P.H. (L'pool). H. R. Hay, M.B., Ch.B. (Edin.), D.P.H., Deputy Medical Officer. (Left May, 1944). C. A. Goggin, M.B., B.Ch., B.A.O., D.P.H., Assistant Medical Officer. K. M. Hart, M.B., B.S. (Lond.), M.D., D.P.H., Assistant Medical Officer. M. Sutcliffe, M.B., B.Ch., B.A.O., T.C.D., D.P.H., Assistant Medical Officer. (Commenced February, 1944). J. A. Cholmeley, F.R.C.S. (Eng.), Orthopaedic Surgeon. . R. Leslie Dodds, F.R.C.S., Consulting Accoucheur. (On Active Service). Miss K. Robinson, F.R.C.S. (Acting for Mr. Dodds). E. Underhill, L.D.S., R.C.S., Dentist. Health Visitor/School Nurses (Combined Service). abde Miss A. Bintcliffe, Lady Superintendent, Health Visitor/School Nurses. (Retired September, 1944). bcdi Miss S. Briggs, Lady Superintendent, Health Visitor/School Nurses. (Commenced November, 1944). de Miss A. Naylor. bd Miss M.Druce. bcd Miss M. R. Hazelton bed Miss R. Bullock. acd Miss J. M. Anderson. bed Miss B. F. Lister. bcd Miss V Garrett bed Miss I Jones bcd Miss J Paterson c Miss A Fahy (School work only). Mrs. C. Tonkin (School work only). Masseuse. Miss G. Kerr, Chartered Masseuse, Orthopaedic Clinic (Part-time). Municipal Midwives. cdfg Mrs. R. K. M. Wingrove, Non-Medical Supervisor of Midwives. cdg Mrs. M. Fitzjohn, Senior Midwife. cdg Mrs. D. S. C. Gazzard. cdg Miss A. G. Walker. cdg Miss K. M. James. cdg Miss D. M. Lewis. cdg Miss V. Ummen. cdg Mrs. A. M. Burton. cd Miss S. Simpson. cdg Mrs. E. Dennison. cdg Mrs. E. Lauchlin. (Commenced January, 1944). d Miss D. V. Curtis. (Commenced February, 1944). d Miss K. A. Blizard. (Commenced May, 1944). a Maternity and Child Welfare Certificate. b New-Health Visitor's Certificate. c State Registered Nurse. d State Certified Midwife. e Sanitary Inspector's Certificate. f Teacher's Certificate of Midwifery. g Certificate for Gas and Air. h Nursery Nurses Diploma. i Diploma of Hygiene. j Reg. Sick Children's Nurse. 24 CLERICAL. Miss R. S. Saunders (Senior Clerk). Miss N. A. Eyres. Miss H. P. Turton. Miss W. S. Beattie. Left September, 1944. Miss J. Blatter. Mrs. V. Carter. MATRONS—NURSERIES. Fore Street h Miss M. W. Betteridge. Hertford Road cj Mrs. I. Drummond. Florence Road c Mrs. L. Myers. Silver Street c Mrs. Mundy. The following information gives details of the Maternity and Child Welfare Clinics at the end of 1944 :— (1) Ante-Natal Clinic at Brookfield House, Fore Street (adjoining the Town Hall). Six sessions weekly. (2) Child Welfare Centres :— (a) Brookfield House. Three sessions weekly. (b) Methodist Church Hall, Bush Hill Park. One session weekly. (c) St. Edmund's Church Hall. Two sessions weekly. (d) Weir Hall. Two sessions weekly. (e) St. John's. One session weekly. (3) Post-Natal and Advisory Clinic at Brookfield House. One session weekly. (4) Dental Clinic at Croyland Road School Clinic. Two sessions weekly. (5) Orthopaedic Clinic at Methodist Central Hall, Fore Street. Two sessions weekly. (6) Obstetric Surgeon attends once a fortnight at Brookfield House. The following information will give some indication as to the work carried out by the Department during the year 1944 :— Births. The total number of births notified during 1944 was as follows :— Live births notified by midwives 2,406 „ „ „ doctors and parents 115 Still-births „ ,, midwives 83 „ „ „ doctors 3 2,607 These figures include births which have taken place in the North Middlesex County Hospital, both of Edmonton and non-Edmonton residents; excluding these latter the notified births of Edmonton residents are :— Live births notified by midwives 1,191 „ „ „ „ doctors and parents 1ll Still-births „ midwives 24 „ „ doctors 2 1,328 25 Number of live Edmonton babies born in outlying institutions 216 Number of still-born Edmonton babies born in outlying institutions 1 217 The following table includes births of Edmonton residents and those born and registered in other districts :— Male. Female. Total. Live Births 793 699 1,492 Still-births 15 13 28 808 712 1,520 Premature Babies. Circular 20/44. Consideration was duly given to Circular 20/44 issued by the Ministry of Health regarding the care of premature infants. Arrangements have been made for additional care and supervision to be given and special records kept in future. Premature children in need of hospital care will be admitted to the North Middlesex County Hospital, as in the past. VISITS PAID BY THE HEALTH VISITORS. The following table gives details as to the visits paid by the Health Visitors :— To expectant mothers :— First visits 53 Total visits 53 To children under 1 year of age :— First visits 1,622 Total visits 10,909 To children between 1 and 5 years of age 12,310 Infant Protection visits to children 5-9 years 63 Visits re adoption 31 23,366 Ante-Natal Clinic. This clinic was held six times weekly and the following are the figures for the year :— Total number of sessions in the year 256 Number of prospective mothers 2,103* Number of consultations 8,916 Total number of attendances 11,129 Average number of attendances :— (a) Per session 43.47 (b) For consultation 34.82 In September a session was started for new cases and general enquiries, but no doctor in attendance. Fifteen sessions were held and 118 new patients attended. A total of 176 mothers attended this clinic. Included in this total are 418 referred from the North Middlesex County Hospital under the scheme of co-operation with that hospital. 26 Post-Natal Clinic. Number of sessions 48 Actual number of mothers who attended 574 Number of consultations 1,145 Total attendances at clinic 1,187 Average attendance per session 24.72 Specialist's Clinic. The Consulting Specialist made 25 visits during the year and saw 201 cases, making an average of 8.04 per session. Child Welfare Clinics. The figures relating to attendances are :— Brookfield House. Methodist Hall. St. Edmunds. Weir Hall. St. Johns. Number of sessions 188 54 104 103 16 New cases—(a) Under 1 year 604 203 265 339 39 (b) 1—5 years 82 20 45 25 4 Attendances—(a) Under 1 year 10,720 3,871 4,265 5,854 810 (b) 1—5 years 5,001 2,419 1,909 4,303 285 15,721 6,290 6,174 10,157 1,095 Average attendances 83,62 116,48 59,36 98,64 68,43 Doctor's consultations 4,732 1,270 2,300 2,730 320 Orthopaedic Clinic. The Clinic is held twice weekly and the following are the figures for the year :— Number of sessions 84 New cases referred during the year 81 Attendances. Surgeon's days 193 Treatment days 429 Total attendances 622 In-patient Treatment. Six children were admitted to Stanmore during 1944. Five children were still in hospital at the end of December, 1944. Dental clinic. Details of the work carried out are :— Mothers. Children. Number of sessions 103 81 Number of attendances 946 260 Number of new cases 310 130 Total number treated 918 256 Fillings 78 405 Dressings 20 Scalings 71 — Extractions (Number of teeth)— (a) Under Gas 1,133 174 (b) Local Anaesthetic 31 — Number of gas cases 349 93 Dentures. Number supplied—77 of whom 55 paid the full cost, 4 were half cost, one was three-quarter cost and 17 were free of charge. 27 Sunlight Clinic. 641 children were referred during the year for sunlight treatment and 2,880 treatments were given. Ophthalmic Clinic. Eighty-two children under 5 years of age attended this clinic during the year. Fifty-three attendances were made for Refraction, 62 for reexamination and 14 for Examination. Birth Control Clinic. Four women were referred to this clinic during the year. Speech Clinic. Arrangements are made with the Education Committee for children under five years of age to attend the Speech Clinic and 5 children were referred during the year. Details of Distribution of Milk, Cod Liver Oil, etc. Distributed by the Maternity and Child Welfare Department apart from any scheme of. the Ministry of Food. Trufood 195 tins. Ostermilk 467 ,, Cow and Gate 1,317 packets.. Cod Liver Oil and Malt 45 cartons. Haly-calcyne 76 packets. Glucose 66 „ Fersolate 26 „ Bemax 2 ,, Free Meals. During the year 5 applications were received, 3 of whom were granted the supply of free meals at the British Restaurants. Convalescent Cases. Six children were sent away under the contract with the Invalid Children's Aid Association and one child was still away at the beginning of the year who had been sent during 1943. Tonsils and Adenoids. Thirty-two children were admitted to hospital for the removal of tonsils and adenoids; of these 18 paid the full cost, one was free of charge, and 13 were through the Hospital Savings Association. INFECTIOUS DISEASES. Ophthalmia Neonatorum. Twenty cases were notified during the year and of these 16 occurred in the North Middlesex County Hospital, 4 of which were Edmonton cases. Of 3 cases which occurred in the district, one was removed to hospital; and one notified from outside district. Puerperal Pyrexia. Eighty-one cases were notified during the year and of this number 71 occurred in the North Middlesex County Hospital of which 16 were Edmonton cases. Six cases occurred on the district and all were removed to the Isolation Hospital, and 4 further cases were notified from the Mothers' Hospital, Clapton. 28 MIDWIFERY SERVICE. Analysis of work. Actual confinements attended by mid- (Of this number 644 as wives 740 midwives and % as Maternity Nurses). Attended by midwives, but women admitted to hospital before or during confinement 157 Left district before confinement or (Attention and supervi- mothers evacuated through L.C.C. sion given by Municipal scheme, etc. 244 midwives during Ante- Natal period). Medical Aid. The number of claims made by doctors for Medical Aid during the year 1944 was 102, of this number 18 cases were granted free of charge, 9 at half cost and the remainder paid the full fee. Gas and Air Analgesia. One hundred and one cases were booked during the year of which 3 were free of charge, one was half cost, and the remainder paid the full cost. Seventy cases had the Gas and Air administered and 31 were cancelled for various reasons. Evacuation of Expectant Mothers under the Government Scheme at the eighth month of pregnancy. The department is responsible for the arrangements in connection with the evacuation of expectant mothers under the Government Scheme and in 1944, 340 mothers applied to be sent away. By December 31st, 242 women had been sent to reception areas for their confinement. Thirty-eight cancelled the arrangements for various reasons. Home Helps. One hundred and twenty-eight women had the services of a Home Help during 1944, 109 paid the full cost, 7 paid half cost, and 12 had the services free of charge. Ante-Natal Scheme of Co-operation between the Council and the North Middlesex County Hospital. Under an arrangement with the Middlesex County Council the Health Visitors visited 48 homes during the year where women applied to the North Middlesex County Hospital for admission and the Authorities desired to have a report on the home circumstances. Sterilised Maternity Outfits. Six hundred and fifteen sterilised maternity outfits were issued during the year, 543 were paid for, 28 paid half cost, and 44 were granted free of charge. X-Rays. Fifteen mothers were referred to the hospital for X-Ray Examination during the year, 12 of whom paid the full cost, 2 half cost, and one was free of charge. CHILDREN UNDER 5 YEARS OF AGE DISCHARGED FROM THE NORTH MIDDLESEX COUNTY HOSPITAL. Fifteen visits were paid to children under 5 years of age who had been discharged from the hospital and it was necessary for them to remain under supervision. 29 ILLEGITIMATE CHILDREN. CIRCULAR 2866. During the year discussions took place with regard to the position of the illegitimate child and its mother, on the lines indicated by Circular 2866 from the Ministry of Health. Every effort is made to assist the women, and a contract has been made with the Middlesex County Council for the admission of women and babies to suitable Hostels. INFANT LIFE PROTECTION. Each Health Visitor employed by the Council is an Officer for Infant Life Protection and great care is taken by them in supervising this part of the work. The number of persons on the register at the end of 1944 was 21 and the number of children 25. Adoption of Children (Regulation) Act, 1939. The Health Visitors are now responsible for the carrying out of this work, viz. :— Number of persons who gave notice under Section 7 (3) during the year 25 Number of children in respect of whom notice was given 25 Number of children under supervision at the end of the year 6 War-time Nurseries. Attendances for the whole year were :— Fore Street 15,149 Hertford Road 10,948 Florence Road 9,226 Silver Street 9,788 (Opened 1st March, 1944) PRIORITY DOCKETS FOR SHEETS. This scheme commenced in November, 1944, and up to the end of December 24 dockets had been issued. 30 BOROUGH OF EDMONTON Educationn Committee 1944 Chairman Alderman W. Preye. Vice-Chairman - Her Worship, the Mayor, Councillor Mrs. F. Long, J.P. Aldermen : A. J. Hollywood, J. Reid, W. F. Middleton, H. Gatward, W. A. Edmunds and Mrs. E. A. Young. Councillors : Mrs. E. M. Hearn, W. Bales, T. H. Jocye, W. Green, G. T. W. Tott, S. W. Creasey, W. H. Coleman and J. A. Ward, J.P. Whole-Time Medical Staff. D. Regan, B.A., B.Sc., M.B., Gh.B., B.A.O., D.P.H. (L'pool), School Medical Officer, Medical Officer of Health and Supervisor of Maternity Services. H. R. Hay, M.B., Ch.B., D.P.H., Deputy School Medical Officer and Deputy Medical Officer of Health. (Left on May, 1944). C. A. Goggin, M.B., Ch.B., D.P.H., Assistant School Medical Officer and Assistant Medical Officer of Health. K. Hart, M.B., B.S. (London), M.D., D.P.H., Assistant School Medical Officer and Assistant Medical Officer of Health. Whole-Time Dental Surgeons. J. F. Ardouin, L.D.S., R.C.S., Senior Surgeon Dentist. E. Underhill, L.D.S., R.C.S., Assistant Surgeon Dentist. F. H. S. Weiss, L.D.S., R.C.S., Assistant Surgeon Dentist (now serving with His Majesty's Forces). Consultants. J. A. Cholmeley, F.R.C.S. (Eng.), Orthopaedic Surgeon. Miss L. M. Smith-Clark, M.B., Ch.B., Ophthalmic Surgeon. J. Browning-Alexander, F.R.C.P., Rheumatic Specialist. W. Ibbotson, F.R.C.S., Aural Specialist. V. A. F. Greenish, L.D.S., R.C.S., Orthodontic Specialist. Part-Time Staff. Miss M. F. Cozens-Walker, Chartered Masseuse. (Left December, 1943). Miss B. N. Oldrey, M.S.S.T., Speech Therapist. Miss G. Kerr, Chartered Masseuse, commenced January, 1944 School Nurses and Health Visitors. Miss A. Bintcliffe (Superintendent). Retired September, 1944. Miss S. Briggs (Superintendent). Commenced October, 1944. Miss A. Naylor. Miss B. Lister. Mrs. C. Tonkin. Miss V. Garrett. Miss A. Fahy. Miss J. Paterson. Miss M. R. Hazelton. Miss M. Druce. Miss J. Anderson. Miss R. Bullock. Miss I. Jones. Miss ButterfielD. Dental Attendants. Miss O. Brooks. Miss J. Collyer. 31 Clerical Staff. B. R. Allen, School Medical Clerk. (Now serving with H.M. Forces). H. A. Carless, Acting School Medical Clerk. S. E. Woodfoffe, Clerk. (Now serving with H.M. Forces). Miss A. Savill, Clerk/Shorthand-typist. Mrs. E. R. Taylor, Clerk. Mrs. P. R. Thorley, Clerk. Miss V. D. Bruton, Clerk. To the Chairman and Members of the Education Committee. Ladies and Gentlemen, I beg to submit my Tenth Annual Report, for the year 1944, on the work of the School Medical Department. As requested by the Ministry of Education the report will be brief, in that it only deals with salient facts, changes in the Department's services, etc. Great difficulties have been experienced during this year in obtaining satisfactory hospital treatment for Tonsil and Adenoid cases. With reference to the treatment, we no longer content ourselves with excising tonsils and adenoids. On the advice of our Aural Consultant many cases did not derive the benefit from tonsillectomy that was expected owing to the secondary infections of the sinuses or deformities of the nasal passage. We have sought and obtained the permission of the Ministry of Education to carry out these extra operations. In the few cases that we have had, very satisfactory results have been obtained. The rest of the School Medical Services are dealt with in my previous reports. Much has been done and will continue to be done in order to raise the standard of efficiency and to take the medical services to all the school population. I would like to express my thanks to the Education Committee for their unfailing courtesy and help on all occasions. It is with regret that this is the last year of our existence as a Local Education Authority. I would also like to say to my staff in general a very hearty " thank you " for their efforts and co-operation during the war years. Without their assistance it would have been impossible to carry on. I have the honour to remain, Ladies and Gentlemen, Your obedient Servant, D. Regan, School Medical Officer. 1. STAFF. There are no staff changes to report for the year 1944. 2. CO-ORDINATION. The co-ordination between the various Departments, general practitioners, Education Offices, and teaching staff ran smoothly as in previous years. 3. SCHOOL HYGIENE. There are no changes to report regarding school hygiene, except in old schools, the sanitary accommodation is old and needs attention. 32 4. MEDICAL INSPECTION. The number of children who received full routine medical inspections for all groups during the year 1944 was 4057. The analysis of the age groups was as follows :— Entrants 968 Second Age Group 2,358 Third Age Group 731 5. FINDINGS OF MEDICAL INSPECTIONS. (a) Malnutrition. The following table shows the classification of nutrition for children inspected in the routine age groups during the year 1944 :— Number Inspected A. B. C. D. 4,057 610 2,728 707 12 (b) Cleanliness. The cleansing of heads and the treatment of scabies continued to be carried out at the Town Hall Inspection Clinic. Scabies reached very high proportions during the year. (c) Minor Ailments and Diseases of the Skin. The only Clinic in this district for the treatment of Minor Ailments is at Croyland Road. The attendances for 1944 were 16,040. (d) Visual Defects and External Eye Diseases. The clinic for the treatment of visual defects was held, as usual, at the Central Hall, Fore Street, N.9. Statistics are given at the back of this report. (e) Nose and Throat Defects and (/) Ear Diseases and Defective Hearing. Mr. William Ibbotson attended the Aural Clinic at the Croyland Road Clinic twice each month. The yearly attendances were :— New Cases : 188. Old Cases : 197. Total 385. Children recommended for the removal of their tonsils and/or adenoids were admitted to the E.M.S. Hospital at Barley Lane, Goodmayes, and the Northern Hospital, Winchmore Hill, N.21. The number of children who received operative treatment during 1944 was 93. Arrangements were also made for children to see the Specialist at the North Middlesex County Hospital, when parents preferred this, and the number of operations carried out there during 1944 was 61. Cases of speech defects were dealt with by the Speech Therapist, and the following is an account of the year's work :— "The speech clinic continued throughout 1944 holding four sessions per week even during the height of the 'flying bomb ' period; attendances were naturally very low during the latter half of June and July but those children who did attend benefitted from the individual treatments which the therapist was able to give them. It is to be regretted that the number of discharges shows a decrease on last year's figure but this is explained by the following (a) Thirty-two children who were attending prior to June 14th have not been seen since, of these only five are actually known to have been evacuated. We have adopted the plan of only partly filling the vacancies so caused in order to minimise the possibility of being unable to re-admit regular attendants returning from evacuation. We have admitted the more serious cases from the waiting list, 33 giving them more individual treatment than has been our custom in the past; this has meant that every 'old case' returning from evacuation has been immediately readmitted for regular treatment. (b) The second factor contributing to a lower discharge figure has been the effect of the raids and consequent nervous tension on the children, particularly the stammerers. The raids in the early spring had a very marked effect on the children. On January 1st, 1944, there were 139 cases on the books, there have been 92 new cases and 5 re-admitted (previously discharged or defaulted). Total 236 : these are accounted for thus :— Discharged 51 Deleted 37 Evacuated 22 (while undergoing treatment) Evacuated 13 (while awaiting treatment) Waiting list 31 Treatment 82 236 One hundred and forty-three school children have received treatment and we start the New Year with 148 cases on the books. ANNUAL COMPARISONS 1938 1939 1940 1941 1942 1943 1944 New Cases 61 66 57 52 96 74 92 Received Treatment 52 85 93 93 122 125 143 Discharged 20 32 23 33 46 61 51 Waiting 100 83 50 45 58 49 44 The Maternity and Child Welfare have referred 7 cases during the year; of these 2 are not considered suitable for immediate treatment but will be recalled for inspection at regular intervals; one has not attended since June and has probably gone away on account of the raids, 3 are receiving regular weekly treatment; one child was found to be in need of a plastic operation before treatment in the speech clinic could be successfully carried out, this child has been admitted to hospital for the operation and as soon as he is well enough he will be re-admitted to the speech clinic for regular weekly treatment. This is the seventh year since the Clinic was opened in 1937. Every effort is made to co-operate with other departments of the School Medical Service especially in connection with those children requiring medical, surgical and dental treatment. It is also very satisfactory that the Child Guidance Clinic has been established in the Borough where further help can be given to those children needing it. The co-operation of the teachers and other members of the staff has been satisfactory. It may interest the Education Committee to know that 630 children have been seen in the Speech Clinic, the results of which have given great satisfaction to the parents and teachers. 34 (g) Dental Defects. The treatment of dental defects was carried out at the Croyland Road and Hazelbury Road Dental Clinics. Particulars of attendances, etc., are given at the end of the report. Orthodontic cases were treated at the above two Clinics, and the attendances for 1944 were :— New Cases. Old Cases Total. 152 1,052 1,214 (h) Orthopaedic and Postural Defects. Orthopaedic defects were, as in previous years, treated at the Special Clinic held at the Central Hall, Fore Street, N.9. Mr. J. A. Cholmeley, the Orthopaedic Specialist, attended the Clinic monthly and Miss Kerr, the Masseuse, attended on Monday, Wednesday, Thursday and Friday mornings. The number of attendances during the year was 2,134. The Surgeon saw 115 New Cases and 208 Old Cases—Total 323. More sessions are needed in order that cases may be followed up and doubtful cases referred in the future. (i) Heart Diseases and Rheumatism. Dr. J. B. Alexander, F.R.C.P., attended the Clinic, held once monthly, for the purpose of examining children suffering from rheumatism and diseases of the heart. Where necessary, arrangements were made for children to be admitted to Heart Homes. The attendances for 1944 were 100 New Cases and 108 Old Cases— Total 208. (j) Tuberculosis. I must extend my most grateful thanks to the Tuberculosis Officer for the co-operation he has given to this Department when dealing with cases referred to him. The number of notified cases and the mortality of children of school age during 1944, taken from the records of the Public Health Department, was :— Notified. Deaths. M. F. M. F. Pulmonary 1 2 — — Non-pulmonary 4 3 — 1 (k) Other Defects and Diseases. These cases were dealt with as in previous years. 6. FOLLOWING-UP. The same arrangements were in effect as in previous years. ARRANGEMENTS FOR TREATMENT. The arrangements for treatment at the various Clinics were as follows :— Croyland Road Minor Ailment Clinic. A doctor was in attendance each morning to advise parents. Rheumatic Clinic. Held the third Thursday in each month—by appointment. Aural Clinic. Held the second and fourth Friday in each month—by appointment only. 35 Ophthalmic Clinic. Held every Monday, with occasional extra sessions. New Cases by appointment only. Orthopaedic Clinic. Held the first Friday in each month. By appointment only. Dental Clinics. Held at Hazelbury Road and Croyland Road Clinics. By appointment only. Orthodontic Clinic. Held once a month at each Clinic. By appointment only. Speech Clinic. Four sessions held each week at Hazelbury Road School. By appointment only. Ultra Violet Light. Held at Central Hall. By appointment only. INFECTIOUS DISEASES. Children suffering from infectious diseases were dealt with in the same manner as in previous years. 36 BOARD OF EDUCATION. Medical Inspection and Treatment Returns. YEAR ENDED 31st DECEMBER, 1944. Table I. MEDICAL INSPECTIONS OF CHILDREN ATTENDING PUBLIC ELEMENTARY SCHOOLS. A.—Routine Medical Inspections. (1) Number of Inspections in the Prescribed Age Groups :— Entrants 968 Second Age Group 2,358 Third Age Group 731 Total 4,057 (2) Number of other Routine Inspections Nil GRAND TOTAL 4,057 B.—Other Inspections. Number of Special Inspections and Re-Inspections 2,157 Table II. CLASSIFICATION OF THE NUTRITION OF CHILDREN INSPECTED DURING THE YEAR IN THE ROUTINE AGE GROUPS. Number of Children Inspected. A. B. C. D. No. % No. % No. % No. % 4,057 610 15.04 2,728 67.24 707 17.43 12. .29 Table III. GROUP I. Treatment of Minor Ailments (excluding uncleanliness). Total Number of Defects treated or under treatment during the ye the Authority's Scheme 5,961 GROUP II. Treatment of Defective Vision and Squint. Under the Authority's Scheme Errors of Refraction (including squint) 1,051 Other defect of disease of the eyes (excluding those recorded in Group I.) — Total 1,051 Number of children for whom spectacles were :— (a) Prescribed 998 (b) Obtained 994 GROUP III. Treatment of Defects of Nose and Throat. Received Operative Treatment 154 Received Other Forms of Treatment 385 Total Number Treated 539 37 Table IV. DENTAL INSPECTION AND TREATMENT. (1) Number of children inspected by the Dentist :— (a) Routine Age Groups 9,450 (b) Specials 1,539 Total (Routine and Specials) 10,989 (2) Number found to require treatment 6,018 (3) Number actually treated 3,124 (4) Attendance made by children for treatment 8,536 (5) Half-days devoted to :— Inspection 53 Treatment 782 Total 835 (6) Fillings :— Permanent Teeth 2,058 Temporary Teeth 84 Total 2,142 (7) Extractions :— Permanent Teeth 1,106 Temporary Teeth 3,478 Total 4,584 (8) Administrations of general anaesthetics for extractions 2,307 (9) Other Operations :— Permanent Teeth 320 Temporary Teeth 3,730 Total 4,050 Table V. VERMINOUS CONDITIONS. (1) Average number of visits per school made during the year by the School Nurses or other authorised persons ... 19 (2) Total number of examinations of children on the schools by School Nurses or other authorised persons 42,783 (3) Number of individual children found unclean 1,022 (4) Number of individual children cleansed under Section 87 (2) and (3) of the Education Act, 1921 767 (5) Number of cases in which legal proceedings were taken :— (a) Under the Education Act, 1921 — (b) Under School Attendance Byelaws — Table VI. BLIND AND DEAF CHILDREN. Number of totally or almost totally blind and deaf children who are not at the present time receiving education suitable for their special needs. At a Public Elementary School. At an Institution other than a Special School. At no School or Institution. Blind Children — — — Deaf Children — — — 38 SECONDARY SCHOOLS. RETURNS IN RESPECT OF CHILDREN ATTENDING SECONDARY AND JUNIOR TECHNICAL SCHOOLS FOR THE YEAR ENDED 31st DECEMBER, 1944. A.—Cases in which a full examination has been made. Age. 9 10 11 12 13 14 15 16 17 18 19 Boys — 1 124 153 136 144 100 33 19 3 — Girls (Sec.) 149 170 115 99 89 25 4 — — (Tech.) — — — 1 70 19 34 9 1 — — Total — 1 273 324 321 262 223 67 24 3 — B.—Classification of the Nutrition of Pupils Inspected During the Year, in Ages. Ages. Number of Pupils Inspected. A (Excellent) B (Normal) C (Slightly Subnormal) D (Bad) 10 1 — 1 — — 11 273 47 193 32 1 12 (Sec.) 321 63 219 39 — (Tech.) 1 — 1 — — 13 (Sec.) 251 60 163 28 — (Tech.) 70 11 50 9 — 14 (Sec.) 243 71 147 25 (Tech.) 19 3 15 1 — 15 (Sec.) 193 63 119 11 (Tech.) 34 1 28 5 — 16 (Sec.) 56 18 36 2 (Tech.) 9 1 5 3 — 17 (Sec.) 23 10 11 2 — (Tech.) 1 — 1 — — 18 3 — 3 — — Total (Sec.) 1,364 332 891 139 1 (Tech.) 134 16 100 18 — 39 C.—Defective Vision and Squint (excluding minor eye defects treated as minor ailments). Number of Defects dealt with. Under the Authority's Scheme. Otherwise. Total. Errors of Refraction (including squint) 162 (Sec.) 162 38 (Tech.) — 38 Other defect or disease of the eyes — (Sec.) — ing those recorded as minor ailments) — (Tech.) — — Totals 162 (Sec.) — 162 38 (Tech.) — 38 Total Number of Children for whom Spectacles were Prescribed :— (а) Under the Authority's Scheme 162 (Sec.) 33 (Tech.) (b) Otherwise — (Sec.) — (Tech.) Total Number of Children who Obtained or Received Spectacles :— (a) Under the Authority's Scheme 154 (Sec.) 32 (Tech.) (b) Otherwise — (Sec.) — (Tech.) D.—Dental Defects. (1) Number of pupils who were :— (a) Inspected by the Dentist :— Ages. 11 12 13 14 15 16 17 18 19 Secondary — 42 102 102 103 56 26 8 — Technical — — 18 76 46 9 — — — Total Secondary—439 Technical —149 Specials Secondary— 66 Technical — 15 Grand Totals Secondary—505 Technical —164 (6) Found to require treatment Secondary—305 Technical —101 (e) Actually treated Secondary—246 Technical — 82 (2) Half days devoted to :— Inspection (Sec.) 3 (Tech. 1) Treatment (Sec.) 47 Secondary— 50 (Tech.) 8 Technical — 9 (3) Attendances by pupils for treatment Secondary—539 Technical —190 (4) Fillings :— Permanent Teeth Secondary—475 Permanent Teeth Technical —148 Temporary Teeth Sec. & Tech. — Total Secondary—475 Technical —148 40 (5) Extractions :— Permanent Teeth Secondary—150 Permanent Teeth Technical — 61 Temporary Teeth Secondary— 16 „ „ Technical Totals Secondary—166 Technical — 61 (6) Administrations of general anaesthetics for extractions :— Secondary— 74 Technical — 33 (7) Other Operations :— Permanent Teeth Secondary—149 Permanent Teeth Technical — 33 Temporary Teeth Sec. & Tech. — Total Secondary—149 Technical — 33 Group 1. Minor Ailments (excluding uncleanliness). Disease or defect. Number of Defects treated, or under treatment during the year. At Minor Ailment Clinic. Otherwise. Total. Sec. Tech. Sec. Tech. Sec. Tech. Skin— Ringworm-Scalp X-Ray — — — — — — Other — — — — — — Body 12 12 Scabies Impetigo 12 12 Other skin disease 82 3 — — 82 3 Minor Eye Defects— External and other, but excluding cases treated at Ophthalmic Clinic 54 10 — — 54 10 Minor Ear Defects 8 10 — — 8 10 Miscellaneous— (E.g., minor injuries, bruises, sores, chilblains, etc.) 103 21 103 21 Total 271 44 41